Descriptive epidemiology of femoroacetabular impingement: A North American Cohort of patients undergoing surgery

John C. Clohisy, Geneva Baca, Paul E. Beaulé, Young Jo Kim, Christopher M. Larson, Michael B. Millis, David A. Podeszwa, Perry L. Schoenecker, Rafael J. Sierra, Ernest L. Sink, Daniel J. Sucato, Robert T. Trousdale, Ira Zaltz

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Background: Symptomatic femoroacetabular impingement (FAI) is associated with hip pain, functional limitations, and secondary osteoarthritis. There is limited information from large patient cohorts defining the specific population affected by FAI. Establishing a large cohort will facilitate the identification of "at-risk" patients and will provide a population for ongoing clinical research initiatives. The authors have therefore established a multicenter, prospective, longitudinal cohort of patients undergoing surgery for symptomatic FAI. Purpose: To report the clinical epidemiology, disease characteristics, and contemporary surgical treatment trends in North America for patients with symptomatic FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Upon approval of the institutional review boards at 8 institutions, 12 surgeons enrolled consecutive patients undergoing surgical intervention for symptomatic FAI. Patient demographics, physical examination data, radiographic data, diagnoses, operative data, and standardized patient-reported outcome measures were collected. The first 1130 cases are summarized in this study. Results: A total of 1076 consecutive patients (1130 hips) were enrolled; 55% (n = 622) were female, and 45% (n = 508) were male, with an average age of 28.4 years and average body mass index (BMI) of 25.1. Demographics revealed that 88% of patients who were predominantly treated for FAI were white, 19% reported a family history of hip surgery, 47.6% of hips had a diagnosis of cam FAI, 44.5% had combined cam/pincer FAI, and 7.9% had pincer FAI. Preoperative clinical scores (pain, function, activity level, and overall health) indicated a major dysfunction related to the hip. Surgical interventions were arthroscopic surgery (50.4%), surgical dislocation (34.4%), reverse periacetabular osteotomy (9.4%), limited open osteochondroplasty with arthroscopic surgery (5.8%), and limited open by itself (1.5%). More than 90% of the hips were noted to have labral and articular cartilage abnormalities at surgery; femoral head-neck osteochondroplasty was performed in 91.6% of the surgical procedures, acetabular rim osteoplasty in 36.7%, labral repair in 47.8%, labral debridement in 16.3%, and acetabular chondroplasty in 40.1%. Conclusion: This multicenter, prospective, longitudinal cohort is one of the largest FAI cohorts to date. In this cohort, FAI occurred predominantly in young, white patients with a normal BMI, and there were more female than male patients. The disease pattern of cam FAI was most common. Contemporary treatment was predominantly arthroscopic followed by surgical hip dislocation.

Original languageEnglish (US)
Pages (from-to)1348-1356
Number of pages9
JournalAmerican Journal of Sports Medicine
Volume41
Issue number6
DOIs
StatePublished - 2013

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Femoracetabular Impingement
Epidemiology
Hip
Arthroscopy
Body Mass Index
Demography
Pain
Hip Dislocation
Research Ethics Committees
Femur Neck
Articular Cartilage
Debridement
Osteotomy
North America
Osteoarthritis
Population
Health Status
Physical Examination

Keywords

  • epidemiology
  • FAI
  • hip arthroscopic surgery
  • surgical hip dislocation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

Clohisy, J. C., Baca, G., Beaulé, P. E., Kim, Y. J., Larson, C. M., Millis, M. B., ... Zaltz, I. (2013). Descriptive epidemiology of femoroacetabular impingement: A North American Cohort of patients undergoing surgery. American Journal of Sports Medicine, 41(6), 1348-1356. https://doi.org/10.1177/0363546513488861

Descriptive epidemiology of femoroacetabular impingement : A North American Cohort of patients undergoing surgery. / Clohisy, John C.; Baca, Geneva; Beaulé, Paul E.; Kim, Young Jo; Larson, Christopher M.; Millis, Michael B.; Podeszwa, David A.; Schoenecker, Perry L.; Sierra, Rafael J.; Sink, Ernest L.; Sucato, Daniel J.; Trousdale, Robert T.; Zaltz, Ira.

In: American Journal of Sports Medicine, Vol. 41, No. 6, 2013, p. 1348-1356.

Research output: Contribution to journalArticle

Clohisy, JC, Baca, G, Beaulé, PE, Kim, YJ, Larson, CM, Millis, MB, Podeszwa, DA, Schoenecker, PL, Sierra, RJ, Sink, EL, Sucato, DJ, Trousdale, RT & Zaltz, I 2013, 'Descriptive epidemiology of femoroacetabular impingement: A North American Cohort of patients undergoing surgery', American Journal of Sports Medicine, vol. 41, no. 6, pp. 1348-1356. https://doi.org/10.1177/0363546513488861
Clohisy, John C. ; Baca, Geneva ; Beaulé, Paul E. ; Kim, Young Jo ; Larson, Christopher M. ; Millis, Michael B. ; Podeszwa, David A. ; Schoenecker, Perry L. ; Sierra, Rafael J. ; Sink, Ernest L. ; Sucato, Daniel J. ; Trousdale, Robert T. ; Zaltz, Ira. / Descriptive epidemiology of femoroacetabular impingement : A North American Cohort of patients undergoing surgery. In: American Journal of Sports Medicine. 2013 ; Vol. 41, No. 6. pp. 1348-1356.
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abstract = "Background: Symptomatic femoroacetabular impingement (FAI) is associated with hip pain, functional limitations, and secondary osteoarthritis. There is limited information from large patient cohorts defining the specific population affected by FAI. Establishing a large cohort will facilitate the identification of {"}at-risk{"} patients and will provide a population for ongoing clinical research initiatives. The authors have therefore established a multicenter, prospective, longitudinal cohort of patients undergoing surgery for symptomatic FAI. Purpose: To report the clinical epidemiology, disease characteristics, and contemporary surgical treatment trends in North America for patients with symptomatic FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Upon approval of the institutional review boards at 8 institutions, 12 surgeons enrolled consecutive patients undergoing surgical intervention for symptomatic FAI. Patient demographics, physical examination data, radiographic data, diagnoses, operative data, and standardized patient-reported outcome measures were collected. The first 1130 cases are summarized in this study. Results: A total of 1076 consecutive patients (1130 hips) were enrolled; 55{\%} (n = 622) were female, and 45{\%} (n = 508) were male, with an average age of 28.4 years and average body mass index (BMI) of 25.1. Demographics revealed that 88{\%} of patients who were predominantly treated for FAI were white, 19{\%} reported a family history of hip surgery, 47.6{\%} of hips had a diagnosis of cam FAI, 44.5{\%} had combined cam/pincer FAI, and 7.9{\%} had pincer FAI. Preoperative clinical scores (pain, function, activity level, and overall health) indicated a major dysfunction related to the hip. Surgical interventions were arthroscopic surgery (50.4{\%}), surgical dislocation (34.4{\%}), reverse periacetabular osteotomy (9.4{\%}), limited open osteochondroplasty with arthroscopic surgery (5.8{\%}), and limited open by itself (1.5{\%}). More than 90{\%} of the hips were noted to have labral and articular cartilage abnormalities at surgery; femoral head-neck osteochondroplasty was performed in 91.6{\%} of the surgical procedures, acetabular rim osteoplasty in 36.7{\%}, labral repair in 47.8{\%}, labral debridement in 16.3{\%}, and acetabular chondroplasty in 40.1{\%}. Conclusion: This multicenter, prospective, longitudinal cohort is one of the largest FAI cohorts to date. In this cohort, FAI occurred predominantly in young, white patients with a normal BMI, and there were more female than male patients. The disease pattern of cam FAI was most common. Contemporary treatment was predominantly arthroscopic followed by surgical hip dislocation.",
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T1 - Descriptive epidemiology of femoroacetabular impingement

T2 - A North American Cohort of patients undergoing surgery

AU - Clohisy, John C.

AU - Baca, Geneva

AU - Beaulé, Paul E.

AU - Kim, Young Jo

AU - Larson, Christopher M.

AU - Millis, Michael B.

AU - Podeszwa, David A.

AU - Schoenecker, Perry L.

AU - Sierra, Rafael J.

AU - Sink, Ernest L.

AU - Sucato, Daniel J.

AU - Trousdale, Robert T.

AU - Zaltz, Ira

PY - 2013

Y1 - 2013

N2 - Background: Symptomatic femoroacetabular impingement (FAI) is associated with hip pain, functional limitations, and secondary osteoarthritis. There is limited information from large patient cohorts defining the specific population affected by FAI. Establishing a large cohort will facilitate the identification of "at-risk" patients and will provide a population for ongoing clinical research initiatives. The authors have therefore established a multicenter, prospective, longitudinal cohort of patients undergoing surgery for symptomatic FAI. Purpose: To report the clinical epidemiology, disease characteristics, and contemporary surgical treatment trends in North America for patients with symptomatic FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Upon approval of the institutional review boards at 8 institutions, 12 surgeons enrolled consecutive patients undergoing surgical intervention for symptomatic FAI. Patient demographics, physical examination data, radiographic data, diagnoses, operative data, and standardized patient-reported outcome measures were collected. The first 1130 cases are summarized in this study. Results: A total of 1076 consecutive patients (1130 hips) were enrolled; 55% (n = 622) were female, and 45% (n = 508) were male, with an average age of 28.4 years and average body mass index (BMI) of 25.1. Demographics revealed that 88% of patients who were predominantly treated for FAI were white, 19% reported a family history of hip surgery, 47.6% of hips had a diagnosis of cam FAI, 44.5% had combined cam/pincer FAI, and 7.9% had pincer FAI. Preoperative clinical scores (pain, function, activity level, and overall health) indicated a major dysfunction related to the hip. Surgical interventions were arthroscopic surgery (50.4%), surgical dislocation (34.4%), reverse periacetabular osteotomy (9.4%), limited open osteochondroplasty with arthroscopic surgery (5.8%), and limited open by itself (1.5%). More than 90% of the hips were noted to have labral and articular cartilage abnormalities at surgery; femoral head-neck osteochondroplasty was performed in 91.6% of the surgical procedures, acetabular rim osteoplasty in 36.7%, labral repair in 47.8%, labral debridement in 16.3%, and acetabular chondroplasty in 40.1%. Conclusion: This multicenter, prospective, longitudinal cohort is one of the largest FAI cohorts to date. In this cohort, FAI occurred predominantly in young, white patients with a normal BMI, and there were more female than male patients. The disease pattern of cam FAI was most common. Contemporary treatment was predominantly arthroscopic followed by surgical hip dislocation.

AB - Background: Symptomatic femoroacetabular impingement (FAI) is associated with hip pain, functional limitations, and secondary osteoarthritis. There is limited information from large patient cohorts defining the specific population affected by FAI. Establishing a large cohort will facilitate the identification of "at-risk" patients and will provide a population for ongoing clinical research initiatives. The authors have therefore established a multicenter, prospective, longitudinal cohort of patients undergoing surgery for symptomatic FAI. Purpose: To report the clinical epidemiology, disease characteristics, and contemporary surgical treatment trends in North America for patients with symptomatic FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Upon approval of the institutional review boards at 8 institutions, 12 surgeons enrolled consecutive patients undergoing surgical intervention for symptomatic FAI. Patient demographics, physical examination data, radiographic data, diagnoses, operative data, and standardized patient-reported outcome measures were collected. The first 1130 cases are summarized in this study. Results: A total of 1076 consecutive patients (1130 hips) were enrolled; 55% (n = 622) were female, and 45% (n = 508) were male, with an average age of 28.4 years and average body mass index (BMI) of 25.1. Demographics revealed that 88% of patients who were predominantly treated for FAI were white, 19% reported a family history of hip surgery, 47.6% of hips had a diagnosis of cam FAI, 44.5% had combined cam/pincer FAI, and 7.9% had pincer FAI. Preoperative clinical scores (pain, function, activity level, and overall health) indicated a major dysfunction related to the hip. Surgical interventions were arthroscopic surgery (50.4%), surgical dislocation (34.4%), reverse periacetabular osteotomy (9.4%), limited open osteochondroplasty with arthroscopic surgery (5.8%), and limited open by itself (1.5%). More than 90% of the hips were noted to have labral and articular cartilage abnormalities at surgery; femoral head-neck osteochondroplasty was performed in 91.6% of the surgical procedures, acetabular rim osteoplasty in 36.7%, labral repair in 47.8%, labral debridement in 16.3%, and acetabular chondroplasty in 40.1%. Conclusion: This multicenter, prospective, longitudinal cohort is one of the largest FAI cohorts to date. In this cohort, FAI occurred predominantly in young, white patients with a normal BMI, and there were more female than male patients. The disease pattern of cam FAI was most common. Contemporary treatment was predominantly arthroscopic followed by surgical hip dislocation.

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KW - FAI

KW - hip arthroscopic surgery

KW - surgical hip dislocation

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